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Abstract
Background: As in most countries around the globe, overweight and obesity are a major threat to public health on the Caribbean island of Aruba. Increasing evidence confirms that breastfeeding protects against overweight and obesity. However, little is known about the mechanism underlying the association between breastfeeding and obesity. One possibility is that breastfed infants are better able to control their meal size and intervals than formula-fed infants. This might lead to a healthier diet in later life and protect against overweight and obesity.
Objective: To determine the relationship between breastfeeding, food pattern and being overweight in the Caribbean.
Methods: In a cross-sectional school-based study in 2004–2005, weight and height were measured by two research assistants in 1776 children aged 6–11 years on Aruba, an island in the Caribbean. BMI was defined according to guidelines by the International Obesity Task Force. Parents completed a questionnaire pertaining to breastfeeding and dietary food pattern.
Results: 1451/1776 (81·7%) children were breastfed; 851/1766 (47·9%) children were breastfed for <4 months, 227/1776 (12·8%) for 4–6 months and 373/1776 (21·0%) for ≧6 months. Children who were breastfed for ≧4 months had lower odds (OR 0·32, 95%CI 0·25–0·40) of being overweight including obesity than those who either were not breastfed or who were breastfed for <4 months. Children who were breastfed for ≧4 months were more likely to have a structured food pattern of six eating moments a day (OR 7·43, 95% CI 5·87–9·39, P<0·001) and to have breakfast every day (OR 2·86, 95% CI 2·17–3·78, P<0·001) than those who were not or who were breastfed for <4 months.
Conclusions: Breastfeeding for ≧4 months is associated with a structured food pattern (six eating moments a day including a daily breakfast) and carries a strikingly lower risk of overweight in children. Promoting prolonged breastfeeding together with a focus on a subsequent structured food pattern could be a cheap method of preventing overweight.
We thank all school principals, teachers and parents for their contribution to the study and the Richard Visser Institute for collecting the data.